Today!

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I’ve said before that in my opinion, the single most important thing you can do to limit the problems of aging is to get to a normal body weight and maintain it. If you’ve been overweight most of your life, as I have been, that can be a real challenge. While the research on what’s called Blue Zones is somewhat controversial, all we have are the observations of different researchers over the years. What seemed obvious to me, as a professional observer, is that people who lived longer seemed to be a normal weight for their height. And to me, that is the absolute goal to work towards.

It’s not easy, and it’s not going to happen overnight. But whether you’re 20, 50, even 70, if it takes you five years to get there, you’re still relatively young. That means that when you do get to be 80, you’ll actually be 80 instead of having died when you were 77. When do you begin to eat less, eat better, and move more to get to that normal weight for height?

Today. No matter how long it’s going to take, you begin today.

Insider Conference Call

I’ve been asked about cyanocobalamin, a synthetic form of vitamin B12. That’s the topic of the evening along with answering personal and product questions. If you’re not an Insider, become an Insider by 8 p.m. Wednesday evening and you can join in the conversation.

What are you prepared to do today?

        Dr. Chet

I’m Alive: V2.55

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When I opened my eyes this morning, I knew I had another year to do what I was created to do: teach people how to be healthy and fit. For those of you who are new readers or those who need a refresher, here’s the story: when I wake on May 10th every year, my superstitious belief is that I have at least one more year to live. My dad died on May 10, 1969. In case you’re wondering, I’m version 2.0 (my father was the first Chester John Zelasko), and it’s been 55 years since my father died. It makes no sense in the real world, especially for a guy who’s a scientist, but every May 10 is a milestone for me.

Last weekend as I pulled into the parking lot where I work out, there was an SUV with a number of plastic bags on the roof arranged in no particular order. As I walked past it, I couldn’t help but notice the car was packed to the ceiling, including the passenger’s seat. In fact, it encroached on the driver’s seat. I don’t know how anyone drives without being able to see the rearview or sideview mirrors, but I guess that person somehow managed. I could speculate whether they were moving or living in their car, but here’s how I saw it.

We all carry the baggage with us—memories of every time we didn’t complete a goal we set, especially health goals. We know the foods we should eat and the ones to avoid. We know that exercise will make us fitter, stronger, and more flexible. We know we have supplements and/or medications we should take for our health or to deal with conditions we may have. In retrospect, we ask ourselves why? Why don’t we do that?

It may not be the only reason or reasons, but I think we carry the baggage of past failures with us. And we continue to lose fitness, strength, and on and on. You know the worst sentence I can think of? “What difference will it make now?” It will make a huge difference. Can you walk your daughter down the aisle, or will you need a walker? Will you need a wheelchair in five years, or can you postpone that? Will you still have the flexibility 15 years from now to take care of your own personal needs, or will you need someone else to bathe you and clip your toenails? In 20 years, will you still be chugging along, or will you be so heavy you can’t stand up without help? I can think of hundreds of examples, but insert your own. It matters.

The important point is that you can change your trajectory. Joining a workout group or taking charge of your diet can make a world of difference in your future, so stop putting it off till next month.

I have my own baggage to deal with, so this version is going to overcome as much of it as I can this year. I’m going to spend the year encouraging you to do the same. We have things to do, and we just have to find a way to drop the baggage and get out of our own way to be the next version of ourselves. All the people who need you will be glad you’re making the effort.

What are you prepared to do today?

        Dr. Chet

Reflections on Family

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I’m going to tell you a story you’re going to find hard to believe. My in-laws, Don and Ruth Jones, were married for over 70 years. Mom died on May 7, 2014, ten years ago; we got the call about 9:30 p.m. Exactly three years later on May 7, at the same time, Dad passed away. I never felt sad about his passing because he was exactly where he had wanted to be for the prior three years—back with Ruthie. But exactly three years, almost to the hour?

Those who knew Ruth and Joner, which was his nickname, knew how close they had been all their adult lives. Ruth shaking her finger at Joner was such an iconic image, their granddaughter, Lori, recreated the scene with her new husband in one of her wedding photos. So it’s easy to imagine Ruthie up in heaven shaking her finger and saying, “Okay, Joner, three years is long enough. Get up here now!” And he went.

Two more short stories. Years ago I had been talking with them about a study on aging. Statistics showed—and still do—that women over 70 can’t lift 10 pounds over their head. As they were unloading groceries, Mom picked up a 10-pound sack of flour and lifted it over her head several times saying, “Look, Chet, I can do that.” It still makes me smile 20 years later. Paula says it was always a waste of breath to tell her she couldn’t do something.

Dad had a number of sayings that he accumulated over the years, but my favorite has to be this one: “Don’t force it—get a bigger hammer.” Spoken like a truck mechanic. Ruth and Joner were a hoot, and I miss their sense of humor. They were all about laughter and unconditional love. I hope the same can be said of us all.

What are you prepared to do today?

        Dr. Chet

Eat Less, Eat Better, Move More—for Life

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In Tuesday’s Memo, Dr. Donal O’Shea suggested that there’s compelling evidence that eating less and moving more won’t result in permanent weight loss because the set point theory is just too strong and will defeat the effort of 90% of the people. However, he didn’t provide any evidence that’s true. I’ll give him the benefit of the doubt, because every study done on diets shows that people do gain back some or all of the weight they lost. He attributes that to the complexity of obesity.

The Complexity of Obesity

Take a good look at the graphic used in the heading. What you can’t read are the 198 determinants (all those gray lines) that contribute to obesity. He narrows them down to just seven categories, five of which are not under the control of people once they are fat. In case it’s difficult to read, here is the list.

  • Societal influences
  • Food production
  • Activity environment
  • Biology
  • Individual psychology
  • Food consumption
  • Individual activity

He also gives a compelling argument that the immune system, working in conjunction with fat cells, causes inflammation in a variety of ways which prevents people from losing weight.

The problem that I have is two-fold. First, it seems the last three are under the control of the individual: eating, moving, and deciding to do so. The exterior forces are what they are, but biology can change. Aging is the perfect example of that.

As for immunity, here’s the real question about the immune system: is it cause or effect? The increase in inflammation is remarkably similar to the increase in cortisol found in people who are obese. Is it the cause of obesity or is it the result of being obese? It makes a difference.

Why Medication Won’t Be the Permanent Solution

Before I get into this, I think that medications may play a role in the solution for some, maybe even most severely overweight people. But they will not be a permanent solution, and the reason may be found in the proteome. You may remember that those are the proteins coded for in our DNA; they range from hormones such as insulin to catalysts for other chemical reactions. There are about 5,000 proteins that are the most researched, but with about 20,000 genes, there may be at least 15,000 more genes that are not researched. That doesn’t count the post-translational modifications, modifications made to the protein as it’s being made; the total could get into the millions.

It’s unrealistic to think that a combination of three, five, or even ten receptor agonists will solve obesity and not cause issues elsewhere in the body by interfering with the production of other necessary proteins. I’m not suggesting that temporary use to get the bulk of weight off an individual won’t be a good way to start, but it’s not a permanent solution as I see it, even if you can afford to take it the rest of your life.

The Bottom Line

The issue with O’Shea’s approach is that it comes from a strictly medical perspective. A nutritional solution isn’t considered and somewhere along the line, just like with gastric bypass, people will exceed their desired caloric intake and regain weight. Why? Because they haven’t learned anything.

Remember, in those seven categories he cited, food consumption and activity levels are under the control of the individual. That means both the quantity and the type of food as well as the amount of activity are under the control of the individual. I’ll say it again: it was, it is, and it will always be about the calories—how much you take in versus how much you use. Take in more than you use, and you gain weight. It’s that simple.

Obesity is complex because our bodies are complicated, but this is still my recommendation: eat better, eat less, and move more. If I were to add two more words that I’ve implied but haven’t stated, they would be “for life” because the only way to hold on to your progress is to keep working on your lifestyle.

What are you prepared to do today?

        Dr. Chet

References:
1. SETU. Understanding Obesity: Rethinking Diagnosis & Treatment. 2024.
2. Nat Chem Biol. 2018 Feb 14; 14(3): 206–214.

Should You Forget “Eat Less, Move More”?

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Eat less. Eat better. Move more.

If you’ve been reading the Health Memo for any length of time, you know that’s my simplified solution, my mantra, to the problem of excess body fat we face in the U.S. and around the world. That’s why an article about an endocrinologist from Ireland who said “Eat less, move more is not the treatment for obesity—get over it” caught my attention. The quote was taken from a talk and interview given by Dr. Donal O’Shea that included a series of recommendations to primary care physicians on how they should approach the topic of excess body weight with patients. He went on to suggest that in a short time, medicine will have solutions for obesity that will essentially render obesity obsolete. Semaglutide is just the first jab at it—pun intended.

I went a little further and listened to a talk by Dr. O’Shea in which he went into detail about why 90% of weight gain is irreversible in 90% of the people. Then he used this example: if you donate a pint of blood, your body will replace it over the next six weeks to get your body back to its blood-volume set point. He says your body weight also has a set point and once it’s raised, it cannot be reversed; no matter what you do, your weight will return to its set point. Therefore, medications such as semaglutide and the ones being developed that will impact other receptors are the only solution.

Should we just buy stock in pharmaceutical companies and forget about nutrition and exercise? Dr. O’Shea is a good scientist and is certainly compassionate toward patients. But is he correct? No, and I’ll explain why on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. Eilish O’Regan. Irish Independent. 04-28-24
2. SETU. Understanding Obesity: Rethinking Diagnosis & Treatment. 2024.

Nobody Got It Right

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The topic of the last Memo came from an article co-written by writers from The Examination and the Washington Post. The “exposé” was that credentialed nutritionists and registered dieticians (RDs) were accepting sponsorships and payments from industries they covered, especially the cereal industry. The “angle” was that the influencers were using the anti-diet movement to promote the consumption of cereals to adults and children—not just granola and oatmeal, but every sugar-laden cereal.

I don’t watch TikTok videos, and I don’t have a TikTok account. But to be fair, I used the hashtag #DerailTheShame to check out some of the videos that were mentioned in the article. It was a couple of weeks after the article was posted, so there were responses from some RDs that typically use TikTok. To say they were upset was an understatement. But in the responses, no one addressed the real issues in the TikToks and the article, so I will.

Both Sides Made Mistakes

The writers who collaborated on the article were all investigative journalists with a lot of experience, but none had a nutrition background. How do you know what’s good or bad from a nutrition perspective? This happens a lot in non-scientific journalism. I’m not saying such articles aren’t worth reading, just keep in mind that an important viewpoint is missing.

Some of the RDs certainly made it seem like they were promoting the sugar-laden cereals only. That’s the problem with using short videos; you don’t get to address the issue completely, and it would appear you have to sell yourself more than anything else.

On the other hand, the RDs were using elements of “fat shaming is bad” together with eating all foods. Fat shaming is bad and should never happen; you don’t know what kind of stressors people are dealing with or the medical, physical, psychological, and budget issues that keep them from losing weight right now. But eating as much processed food as you want isn’t a good solution.

At least one of the authors of the article wrote about Big Food and their sponsorships of RDs. The results were new laws legislating that compensation must be revealed when it comes to such influencers. On the other hand, I didn’t find any criticism by the RDs of Big Food companies who oppose new and plainly written food labels to reveal exactly what’s in processed foods.

Partial Solutions

I think the article writers should have spent more time on the Big Food angle rather than the influencers, credentialed or not. Many health insurance companies will not pay for nutritional counseling for obesity. One of the results is that nutrition professionals turn to other venues to be able to earn a living, and sponsorships can help them do that.

As for the credentialed influencers? With all the mind-numbing music, graphics, and dancing around in kitchens, it seems appropriate to post the serving size and calories from the cereal (or whatever food is being promoted) and to emphasize sticking to reasonable portions per day. That solves the issue in my mind. I’m not opposed to earning a living.

The Bottom Line

While cereals and any processed food have their place in a healthy diet, they should be eaten in the proper serving size and servings per day. I am opposed to the anti-diet sentiment. The only way to lose weight and maintain it is to eat less, eat better, and move more. (Ozempic isn’t magic; people lose weight because the drug causes them to eat less.) We all have to figure out for ourselves how to do that, and it won’t be the same for everyone, but it’s the only way to solve the obesity epidemic we face.

However, a physician from across the pond says that eating less and moving more just won’t work. That’s our topic for next week.

What are you prepared to do today?

        Dr. Chet

Reference: 04-03-24. Washington Post. As Obesity Rises, Big Food and Dietitians Push ‘Anti-Diet’ Advice.

What Should You Believe?

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What happens when you mix:

  • Social media
  • Certified expert influencers such as dieticians
  • The food industry paying or sponsoring food influencers
  • The message that dieting is wrong

You get up to 40% of the social media influencers saying, “Why diet? Love yourself and eat whatever you want!”—especially cereals or other highly sweetened grain products. You get partial truths that bastardize the original concepts of loving yourself and end up with people confused and, in some cases, fatter than they have ever been.

Welcome to a new reality. I think we expect that people who talk about health will have their own point of view; I certainly do. Some people believe that being a vegan is the only way to eat while others believe that a ketogenic diet is the absolute best. Both can selectively use research to support their opinion—and do. That seems normal because everyone can have a point of view.

But what if an organic farming association were paying the vegan supporter to promote a vegan diet? How about beef producers paying the ketogenic diet promoter to favor not only meat but especially beef? That connection must be reported in any scientific study about specific diets, but if you’re an influencer, that’s not mandated.

What about nutritionists and registered dieticians that are supported in part by the food industry? Could they take that too far? We’ll see on Saturday.

And just for the record, no company pays me—only you do when you join drchet.com, buy my health-info products, attend my seminars and webinars, or book me to speak to your group. I work for you.

What are you prepared to do today?

        Dr. Chet

Reference: 04-03-24. Washington Post. As Obesity Rises, Big Food and Dietitians Push ‘Anti-Diet’ Advice.

Obesity and Prenatal Omega-3s: Premature Conclusions

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Women frequently ask about prenatal supplementation, and omega-3 fatty acids are always part of prenatal recommendations; that’s why this study attracted my attention. Did they come to the right conclusions? I think the best place to begin is by reading the conclusion statement of the abstract, and then examine the data from the paper to see if it supports those conclusions.

Here we go:

“In this randomized clinical trial, children of mothers receiving omega-3 fatty acid supplementation had increased BMI at age 10 years, increased risk of being overweight, and a tendency of increased fat percentage and higher metabolic syndrome score. These findings suggest potential adverse health effects from n-3 long-chain polyunsaturated fatty acid supplementation during pregnancy and need to be replicated in future independent studies.”

Problems with the Conclusions

The difference in body weight was two pounds, with the fish oil group weighing more than the placebo group; neither group was classified as being overweight by international standards. With height being equal, that automatically meant that the BMI would be higher in the fish oil group. However, both groups would be classified as underweight based on standards for children five to ten years old. The implication was the omega-3 group might be overweight. They were not; in fact they were closer to normal weight than the lighter kids. The increased risk of being overweight isn’t supported by the data presented.

Related to the higher metabolic syndrome score, the researchers calculated the score using an algorithm that considered waist circumference, systolic BP, negative HDL cholesterol, the log of triglycerides, and the Homeostatic Model Assessment for Insulin Resistance or HOMA-IR for short. There was a difference of 3/10 of an inch in waist circumference, with the omega-3 group being slightly larger. There was no difference in triglyceride levels, and the omega-3 group had a higher HDL cholesterol level than the control group. There was no difference in systolic blood pressure between the groups. That leaves us with the HOMA-IR calculation.

Typically, serum insulin would be used in the calculation to determine the HOMA-IR number. They didn’t collect insulin data, so they used another indicator of insulin levels in calculating the HOMA-IR. The problem is that that algorithm was based on 21 adult subjects; it was never validated with a larger group or for use in children. I question its use, but for argument’s sake, let’s say it doesn’t matter.

The Real Problem

The real problem that I have is with the remark about a tendency towards increased percent body fat. When they assessed body composition at 10 years of age, they used bioelectrical impedance analysis (BIA). I worked on comparing methods of body composition analysis when I was a graduate student, so I can tell you from experience that underwater weighing is the gold standard for any group (and, yes, I’ve underwater weighed 10-year-olds). Specifically, there are two factors that are always concerning with BIA:

  • The algorithm is 95% dependent on height and weight. A two-pound difference in body weight in children could impact the calculation, even if the actual body composition was the same.
  • BIA is sensitive to fluid levels of the body. It assesses total body water and calculates fat mass by making an assumption about the water content of the remaining tissues. It’s not the best way to assess body fat in a major study such as this.

The Bottom Line

How?!!!

We hear that a lot when our grandson plays a videogame. When something happens that he doesn’t anticipate or understand, he yells “How?!!!” and that’s what I’m thinking right now. The most frustrating part of this research paper is their conclusion that omega-3 supplementation in the last trimester of pregnancy may result in adverse effects to the children.

How? How would supplementing with omega-3 fatty acids cause the offspring to have an increased risk of being overweight or obese? They did not provide any comment on how that could occur.

As it stands now, we really don’t know much more about omega-3 supplementation in the third trimester of pregnancy other than the kids whose mothers took omega-3 fatty acid had fewer serious asthma and allergy symptoms; because the incidence of asthma and allergies are rising steadily, that may be the most important observation from this study so far.

As for body composition? Not so much. This study will continue until the subjects are adults, so maybe further testing will yield more conclusive results.

What are you prepared to do today?

        Dr. Chet

Reference: AJCN. 2024. doi.org/10.1016/j.ajcnut.2023.12.015

Obesity and Prenatal Omega-3s

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Scientists continue to research the causes of obesity. For many, as we’ll see, it’s not as simple as eating less and moving more; in the study I’m going to review this week, the researchers are going prenatal.

The Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC) is an ongoing longitudinal study to examine the effects of omega-3 supplementation in the third trimester of pregnancy on a number of factors. The primary objective was to see if allergies and asthma were reduced in the offspring of women who took the omega-3s versus those who took a placebo. Asthma or persistent wheeze showed a 31% reduction in risk in the group receiving fish oil compared to 23% the placebo group.

The researchers also collected a variety of anthropometric data, plus blood samples for metabolic and blood lipid analysis, and assessed body composition. In a prior paper when the children were age six, the omega group were about one pound heavier but with a proportional increase in lean and fat mass.

In the current analysis at age ten, the omega group were determined to have an increased BMI, increased risk of being overweight, a tendency for increased fat percentage, and higher metabolic syndrome score when compared to the placebo group. That doesn’t sound good. Does this mean women should avoid omega-3 fish oil during pregnancy, especially the third trimester? I’ll let you know on Saturday.

Tomorrow is the monthly Insider Conference Call. I’m going to cover starvation but not the Minnesota Starvation Study—you’ll come away stunned. I’ll also answer your questions. If you’re not an Insider, become one by 8 p.m. tomorrow and you can join in.

What are you prepared to do today?

        Dr. Chet

References:
1. BMJ 2018. doi: https://doi.org/10.1136/bmj.k3312
2. AJCN. 2024. doi.org/10.1016/j.ajcnut.2023.12.015

The Ridiculous: Obesity and Weight Loss Scams

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As I planned this series of Memos, I wrestled with using the word “obesity” because everyone appears to hate that term—especially when directed at themselves. I decided to stick with it because it afflicts close to 40% of us in the United States. Before I get to ridiculous weight loss plans people are hawking, how did we get here?

Obesity is the product of success. We’ve been successful in creating so many labor-saving devices, we can’t burn enough calories in everyday activity anymore. We’ve successfully produced so much food, available just about everywhere, and made to appeal to all our tastes—sweet, salty, fatty, and umami. They’re hard to resist. The U.S. and Canada have worked hard to produce so much food. But with that success comes overconsumption. Pure and simple.

I question whether obesity is a disease. The dieticians and nutritionists have tried health education without success. Now the medical community has taken over with surgery and pharmaceuticals. And we’re still getting fatter, not because we’re failures but because we’re reaping the rewards of success. We have to change our approach to how we treat food if we’re going to be successful in changing the outcome.

In this series, I’m going to cover recent ads, commentaries, and research on obesity and weight loss. Let’s begin with a Facebook ad my daughter-in-law sent Paula the other day.

The Ridiculous

Paula got a text from Kerri that showed the benefits of MagnaGermanium earrings; these magnetic earrings will activate your lymphatic system, drain away toxins, detox your body, and allow you to lose weight naturally. I had to check it out—after all, it was FDA approved!

It was just a bunch of testimonials. No science, even though the ad referred to it. Claimed to be made in an FDA-approved facility, but there’s no such classification. It’s a pure scam but reasonably priced: just $22.97 a pair in the ad I reviewed. Look around a little, and you can find them for one cent; that tells you all you need to know about the quality.

I don’t think I have to say anything else. By the way, those Kelly Clarkson “ads” for Keto-ACV Gummies? Worst artificial intelligence effort I’ve seen so far. They’re also in the ridiculous category.

We’re just getting started. Next week, a look at fish oil and the potential for overweight children. You don’t want to miss it.

What are you prepared to do today?

        Dr. Chet